ONGOING PROJECTS

Imaging Unit

The aim of this randomized controlled study is to investigate the changes in MRI-based estimates of synovitis following an exercise program preceded by an intra-articular injection with either glucocorticoid or isotonic saline (placebo). We will furthermore investigate if any of the changes in the patient reported outcome measures are paralleled by changes in the MRI-assessments of synovitis.

The aim of the study is to predict histological synovitis in end-stage knee osteoarthritis using different MRI techniques, including dynamic contrast-enhanced MRI. Synovial biopsies are obtained intraoperatively (total knee arthroplasty) and the MRIs are performed prior to surgery.

Chronic pain is the major clinical trait in rheumatologic diseases, varying from non-inflammatory conditions, such as widespread pain syndrome (fibromyalgia), to systemic inflammatory diseases, such as rheumatoid arthritis and diseases characterized by localized joint degeneration and inflammation, such as knee osteoarthritis. Depending on the disease, different pain mechanisms may be involved. Widespread pain syndrome is considered the prototypical central pain syndrome and research have highlighted the role of central pain processing mechanisms, such as sensitization of pain transmitting neurons and dysfunction of descending inhibitory pain pathways. The objective of the series of fMRI and pain studies is to use functional magnetic resonance imaging to objectively evaluate brain-activation patterns involved in chronic pain patients, and during application of experimental deep tissue pain to determine whether these patterns are consistent with an augmented central pain processing in patients with knee osteoarthritis, rheumatoid arthritis and fibromyalgia.

Investigators

Elisabeth Bandak, Marius Henriksen, Mikael Boesen

Summary

In patients with knee OA retrospective data on Dynamic Contrast Enhanced MRI (DCE-MRI) of the thigh and knee, systemic markers (blood samples, synovial fluids), assessments of mobility (muscle strength, Six-minute walk test, and biomechanical gait analysis) will be analyzed. Further, patient reported outcomes on pain, symptoms, and physical function in patients is acquired using questionnaires are available and will be included in the analyses.

Clinical Research Unit

Investigators

Henning Bliddal (principal investigator), Signe Rifbjerg-Madsen, Anton W Christensen, Bjarke B Hansen, Mikael Boesen

Sponsor

AbbVie

Summary

Joints with osteoarthritis are characterized by inflammation in many instances. The inflammation may cause tissue damage, while also be a major contributor to the clinical problems with the joint, especially pain. Over the years, joints with inflammation have been treated with injection of glucocorticosteroids to deal with this problem. This treatment, however, is not a lasting solution to the inflammation and there is a demand for other medications with anti-inflammatory properties. In this project, subjects with defined signs of inflammation in the osteoarthritic knee joint will be enrolled in a RCT. Test drug is acting on Il-1 and the effect will be followed both clinically and by imaging, in this case dynamic contrast enhanced MRI. The randomization has 4 arms with one placebo and three active, with a distribution 1:2:2:2. The test medication is given as injection every 2 weeks for a year.